Why must RAAS blockade be monitored carefully in CKD for electrolyte disturbances, and what lab value is critical to track?

• A. Hyperkalemia risk; track serum potassium and liver enzymes
• B. Hyperkalemia risk; track serum potassium and kidney function
• C. No electrolyte risk; monitor electrolytes only if symptoms
• D. Hypokalemia risk; monitor serum potassium and glucose

Answer: (D)

RAAS blockade can raise potassium levels because aldosterone helps the kidneys excrete potassium. In CKD, fewer functioning nephrons mean reduced potassium excretion, so blocking the RAAS increases the risk of hyperkalemia. The most important lab to monitor is serum potassium to detect rising levels. In addition, tracking kidney function (creatinine/eGFR) is essential to see how the therapy impacts overall renal function and to guide dose adjustments or discontinuation if potassium climbs or kidney function worsens. Liver enzymes and glucose aren’t the primary concerns for this electrolyte issue, and the risk in this context is hyperkalemia rather than hypokalemia.